
<?php

use yii\helpers\Url;

?>
<div class="containerBottom">
<div id="limgDiv">
    <img src="<?=Url::to('@web/member/img/cardImg.png',true)?>" class="lcardImg"> <!--图片需要重新传-->
</div>

<form action="" method="post" id='register_form'>
    <div class=" bd weui_cells weui_cells_form">
        <div class="weui_cells_title">必填信息</div>
        <div class="weui_cell" id="lname">
            <div class="weui_cell_hd"><label class="weui_label">姓名</label></div>
            <div class="weui_cell_bd weui_cell_primary">

                <input class="weui_input" type="text" placeholder="请输入您的姓名" id="linputName" name="last_name"value="">
            </div>
        </div>
        <div class="weui_cell">
            <div class="weui_cell_hd"><label class="weui_label">手机号码</label></div>
            <div class="weui_cell_bd weui_cell_primary">
                <input class="weui_input" type="text" name="phone" placeholder="请输入您的手机号码">
            </div>
        </div>
        <div class="weui_cell weui_cells_access">
            <div class="weui_cell_hd"><label class="weui_label">验证码</label></div>
            <div class="weui_cell_bd weui_cell_primary">
                <!--手机的验证需要写-->
                <input class="weui_input" type="text" placeholder="请填写验证码">
            </div>
            <div class="weui-cell__ft" id="lsendCode">
                发送验证码
            </div>
        </div>

        <div class="weui_cell">
            <div class="weui_cell_hd"><label for="re_gender" class="weui_label">性别</label></div>
            <div class="weui_cell_bd weui_cell_primary">
                <!-- <input class="weui_input" type="text" value="" name="gender" id='re_gender' placeholder="请选择性别"/> -->
                <select name="gender" class="weui_input">
                    <option value='F'>男</option>
                    <option value='N'>女</option>
                </select>
            </div>
        </div>
        <div class="weui_cell">
            <div class="weui_cell_hd"><label class="weui_label">生日</label></div>
            <div class="weui_cell_bd weui_cell_primary">
                <input class="weui_input" type="date" name="birthday" placeholder="请选择您的生日">
            </div>
        </div>
        <div class="lhr"></div>
        <div class="weui_cells_title">选填信息</div>


        <div class="weui_cell" id="lemail">
            <div class="weui_cell_hd"><label class="weui_label">邮箱</label></div>
            <div class="weui_cell_bd weui_cell_primary">
                <input class="weui_input" type="text" name="email" placeholder="请输入邮箱地址">
            </div>
        </div>

        <div class="weui_cell">
            <div class="weui_cell_hd"><label class="weui_label">收货地址</label></div>
            <div class="weui_cell_bd weui_cell_primary">
                <input class="weui_input" type="text" name="address1" placeholder="请输入收货地址" id='city-picker'>
            </div>
        </div>

        <div class="weui_cell">
            <div class="weui_cell_hd"><label class="weui_label">职业</label></div>
            <div class="weui_cell_bd weui_cell_primary">
                <input class="weui_input" type="text" name="work" placeholder="请填写您的职业">
            </div>
        </div>
    </div>

    <label for="weuiAgree" class="weui-agree">
        <input id="weuiAgree" class="weui-agree-checkbox" type="checkbox" onclick ='check(this)'>
        <span class="weui-agree-text" id="linputAgree">
            我已阅读并同意<a href="javascript:void(0);" class="llink">会员守则</a>和
                    <a href="javascript:void(0);" class="llink">会员卡信息使用声明</a>
        </span>
    </label>
    <div class="weui_btn_area">
        <!-- <a class="weui_btn weui_btn_primary" href="register" id="showTooltips">立即开卡</a> -->
        <input class="weui_btn" type="submit" value="提交" disabled='disabled' id="regSub">
        <input name="_csrf" type="hidden" id="_csrf" value="<?= Yii::$app->request->csrfToken ?>">
    </div>
</form>
</div>
